Try for free

FAA CACI Prediabetes Worksheet for Pilots

Pilots with prediabetes, metabolic syndrome, impaired fasting glucose or insulin resistance can be certified in the AME's office through this Conditions AMEs Can Issue (CACI) checklist, including those taking a diabetic medication for weight loss. The AME reviews a progress note from within 90 days of the exam and checks A1C history, medication and hypoglycemia. A pilot whose A1C has ever been 6.5% or higher cannot use it.

Who completes it

The AME completes the checklist and marks the Block 60 outcome. The treating physician or prescribing provider writes the current, detailed Clinical Progress Note that the AME reviews.

Submitting and payment

How to submit it
A qualifying case is noted as 'CACI qualified prediabetes' in Block 60 of FAA Form 8500-8. If any item is not met, the AME defers and submits the supporting documents to the FAA.

Good to know

  • Current A1C must be within the last 90 days and 6.4% or less, with no A1C of 6.5% or greater ever. Diabetes in remission, treated diabetes and diabetes insipidus do not qualify.
  • Only one medication may be used: metformin, liraglutide, semaglutide (Wegovy, injection or oral) or tirzepatide (Zepbound).
  • The AME verifies a one-week observation after starting the medication and a 48-hour observation after each dose increase, medication or formulation change.
  • There can be no hypoglycemic events (symptoms or glucose 70 mg/dL or less) requiring intervention in the past 12 months, no diabetes complications and no medication side effects.

Get the official form

Download the current version from the source each time; forms change without notice.

CACI – Prediabetes Worksheet

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

See how Vero Documents works

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Can a pilot take Wegovy or Zepbound under the prediabetes CACI?

Yes, as the only medication. The worksheet accepts one of metformin, liraglutide, semaglutide (Wegovy, injection or oral) or tirzepatide (Zepbound). The AME verifies a one-week observation after starting and a 48-hour observation after any dose increase, medication or formulation change.

What A1C is allowed for the FAA prediabetes CACI?

A current A1C from the last 90 days of 6.4% or less, and no A1C of 6.5% or greater at any time. The worksheet notes that 6.5% or greater is diagnostic of diabetes under ADA criteria, and tells the AME not to use this CACI for a pilot who has ever reached it.